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To Your Good Health: Tips for IBS and Similar Ailments

Dear Dr. Roach: Some time ago, there was a letter from a woman whose spouse was having intestinal problems. Specifically, he would have a bowel movement every time he ate, often four to five times a day. Usually, he would have to rush to get to the bathroom in time. My husband has this same problem, and his father did also. He has had regular colonoscopies and has tried probiotics and lactose supplements, to no avail. Do you have any answers or ideas? Thank you. — R.W.

Answer: Needing to rush to the bathroom for a bowel movement after eating is called the gastrocolic reflex (“gastro” denoting “stomach,” “colic” being “colon”). It is common to get it occasionally, but in some people it is quite pronounced. A powerful gastrocolic reflex is suggestive of irritable bowel syndrome. IBS is a condition of unknown cause that combines abdominal discomfort with changes in bowel habits. It is very common, and ranges in severity from mildly annoying to so severe that people’s social and work lives can be impacted significantly. It doesn’t shorten lifespan or cause cancer. More women then men have IBS.

Even if your husband doesn’t have irritable bowel syndrome, he still may get benefit from some simple steps that help most people with IBS. These include avoiding dairy, increasing fiber and getting exercise. A food diary to correlate symptoms with particular foods can help identify and eliminate foods from the diet that are problematic. Eating more slowly and at specific times also helps most people. Every source says to reduce stress, but that isn’t always so easy to do.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475. Hello Dr. Roach: I have been a “jock” all my life and have been told that I have an athletic heart. I play racquetball six days a week and will be 80 years old in July. Since the heart is a muscle, shouldn’t my systolic pressure be higher than normal? — H.N.

Answer: Happy birthday.

Getting regular exercise is one of the best ways to keep your heart healthy. But the heart isn’t like other muscles. Most muscles get big when they are regularly exercised, but the heart has only minimal change in size. An enlarged heart almost always is a diseased heart.

The heart rate in a trained athlete usually is low. Some professional and competitive amateur athletes have heart rates in the 40s or even 30s. Those levels in a non-athlete might lead to a pacemaker. Blood pressure also tends to drop in athletes, as much as five to 15 points. Many of these changes aren’t what we would expect. Your doctor needs to know that you are an athlete in order to interpret your heart and pulse properly.

Dear Dr. Roach: I am wondering how to improve my kidney function. Lately, when I have blood work done, the doctors say it is getting worse. I have an appointment with a kidney specialist. I am 76 years old. — B.F.

Answer: Kidney function naturally declines somewhat with age, but many conditions can cause a decrease in kidney function. High blood pressure and diabetes probably are the two most common, but medications can have an effect as well. I am sure the kidney specialist will carefully look over any medications you may be taking. Some medicines need to be adjusted for kidney function; others help preserve it.

Managing any existing conditions often is the first step in preserving kidney function, since once it is gone, it seldom comes back.

Talk to your kidney specialist about your diet; for many cases, a low-protein diet can prevent kidney function from worsening. Also, if your kidney function is already quite low, you may need to limit potassium from food.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475.